title: Short-term very low-calorie diet in obese females improves the haemostatic balance through the reduction of leptin levels, PAI-1 concentrations and a diminished release of platelet and leukocyte-derived microparticles.
abstract: BACKGROUND
  In obesity, metabolic stress and inflammation in injured tissues could favour enhanced shedding of procoagulant microparticles (MPs). At sites of endothelium injury, the swift recruitment of procoagulant leukocyte-derived MPs enables the initiation of blood coagulation and thrombus growth.
  
  
  OBJECTIVE
  In obese females, we sought to evaluate the impact of a very low-calorie diet (VLCD) on procoagulant MP levels, fibrinolytic status, inflammation and endothelium damage.
  
  
  METHODS
  Circulating biomarkers of vascular damage, fibrinolytic status, platelet activation and inflammation were measured before, 30 and 90 days after starting a short-term VLCD. MPs were measured by flow cytometry and capture assays. Their procoagulant potential was quantified using functional prothrombinase assays and their cellular origin were determined using flow cytometry (endothelium, platelet, leukocyte, lymphocyte and erythrocyte-derived MP) or capture assays.
  
  
  RESULTS
  A total of 24 obese females (39 ± 10 years) with a mean body mass index of 35 ± 4  kg m(-2) were prospectively enroled. Procoagulant leukocyte-derived MPs were associated with the waist circumference at baseline (r=0.534; P=0.010) and at 90 days follow-up (r=0.487; P=0.021). At 90 days, weight reduction (-9.8%) was associated with a lowering of blood pressure, improvement of metabolic parameters and a significant reduction of plasminogen activator inhibitor-1 (PAI-1) (-38%), procoagulant platelet-derived MPs (-43%), leukocyte-derived MPs (-28%) and leptin (-32%) levels.
  
  
  CONCLUSIONS
  In obese females, a short-term VLCD results in an overall improvement of the haemostatic balance characterized by the reduction of PAI-levels, diminished release of platelet and leukocyte-derived MPs and a reduction in leptin levels, an adipocyte-derived cytokine.
authors.affiliation: Pôle d'activité médico-chirurgicale Cardiovasculaire des Hôpitaux Universitaires de Strasbourg, Nouvel Hôpital Civil, place de l'Hôpital, Université de Strasbourg, Strasbourg, France. olivier.morel@chru-strasbourg.fr
authors.forename: O
authors.initials: O
authors.lastname: Morel
authors.forename: F
authors.initials: F
authors.lastname: Luca
authors.forename: L
authors.initials: L
authors.lastname: Grunebaum
authors.forename: L
authors.initials: L
authors.lastname: Jesel
authors.forename: N
authors.initials: N
authors.lastname: Meyer
authors.forename: D
authors.initials: D
authors.lastname: Desprez
authors.forename: S
authors.initials: S
authors.lastname: Robert
authors.forename: F
authors.initials: F
authors.lastname: Dignat-George
authors.forename: F
authors.initials: F
authors.lastname: Toti
authors.forename: C
authors.initials: C
authors.lastname: Simon
authors.forename: B
authors.initials: B
authors.lastname: Goichot
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D001779:Blood Coagulation Factors / Q000378:metabolism*; D001792:Blood Platelets / Q000378:metabolism*; D031204:Caloric Restriction; D004730:Endothelium, Vascular / Q000378:metabolism; D004912:Erythrocytes / Q000378:metabolism; D005260:Female; D006487:Hemostasis; D006801:Humans; D020738:Leptin / Q000097:blood* / Q000378:metabolism*; D007962:Leukocytes / Q000378:metabolism*; D008875:Middle Aged; D009765:Obesity / Q000097:blood* / Q000178:diet therapy / Q000378:metabolism; D017395:Plasminogen Activator Inhibitor 1 / Q000378:metabolism*; D011446:Prospective Studies; D013925:Thromboplastin / Q000378:metabolism; D013927:Thrombosis / Q000378:metabolism; D015431:Weight Loss; D055815:Young Adult
chemical_list: D015415:Biomarkers; D001779:Blood Coagulation Factors; D020738:Leptin; D017395:Plasminogen Activator Inhibitor 1; C045071:leukocyte procoagulant activity; D013925:Thromboplastin